We attended the AfricaCom 2020 convention in Cape Town last November 2017 and caught up with some of the EHealth experts present there to try and get a better feel for what is happening in this field. We asked them about the need for EHealth solutions, examples of what is currently out there and how these digital healthcare solutions work.

The definition of EHealth

Ehealth refers to the digitization of healthcare; putting digital tools in the hands of healthcare professional and patients. “In practice this encompasses many aspects of digital health, including: electronic patient management systems, digital health records, mHealth or mobile solutions, telemedicine and much more”, explains Taryn Springhall, Editor at eHealthNews.

Status of EHealth today in South Africa

In South Africa there are a number of universities involved in developing digital health solutions. Provincial Departments of Health have some embedded systems, medical aides have in-house systems, and a vast array of players are involved in coming up with for- or non-profit solutions for health care problems – some of whom work in other African countries as well.

One of the bigger organizations in the NGO space is Jembi Health Systems who are http://www.ifg.cc/administrator/index.php?option=com_content&view=article&layout=edit&id=55523#digitizing various aspects of the patient journey, data collection, systems development and more. Others include Praekelt Foundation, BroadReach, Measure Evaluation, Right to Care (eRight Pharmacy) as well as those dedicated specifically to mobile or mHealth, such as hearX group, Recomed, GetHealth, and EMguidance (TOMPSA). From a supplier perspective multinationals such as Intersystems, Med-e-Mass and Discovery play an integral part in digitizing healthcare.

Status of EHealth today in the world

EHealth solutions aimed at both private and public use are making advances all over the world; whether it’s digitally connecting health workers in extremely remote parts of Swaziland to specialists or advancing data centralization and preservation in the USA, there are many geographical and thematic areas in which digitization can be more effective and cost-reducing.

Ms Springhall reminds us the opportunities can be both limited and opened up by the regulatory environment EHealth providers work:

“Regions like the US, UK and Europe have made advances in incorporating eHealth as an integral part of the health system. What we see as a common thread between those different countries is political leadership to move from paper based systems to digital ones. Reforms like the Affordable Care Act, Meaningful Use program and the UK’s Personalised Health and Care 2020 are about leveraging public health data, reducing waste and costs, relooking at reimbursement models, filling gaps in infrastructure and alleviating some of the burden on healthcare workers. I’d like to see South Africa adopt the same attitude to eHealth in that we’re using electronic systems to help us answer some of those same questions.”

Registration and regulations around EHealth solutions

In South Africa medical mobile apps need to be compliant with Data Security legislation as well as the POPI Act. Legal council is usually needed to ensure that all aspects of the app or device are compliant and that any changes we made were also compliant. In terms of devices, The South African Health Products Regulatory Authority (SAHPRA) owns the certification and licensing process in SA.

Public versus Private

Most EHealth players are explicitly Business-to-Business (or organization-to-organization) oriented, or have the specific goal of working to help make the public health sector work more efficiently; in either case the ultimate goal is to improve and increase access to quality health care. Vula mobile for example also does not cater directly to consumers, but is only used by registered health professionals and has effectively served over 23,000 patients in South Africa thus far.

“It (Vula mobile chat app) essentially connects your local caring health worker with specialists, so that you get specialist guided healthcare wherever you are, and your local caring health worker learns case by case to provide even better care in the future,” explains Dr. William Mapham of Vula Mobile.

Dictum Health hopes to start operations in South Africa in 2018. Alfie Martin tells us: “We have engaged with the National Health Service and Health Insurance in South Africa and demonstrations of our Virtual Exam Room (VER) solution has been well received. We are working towards a number of test deployments early in 2018 in both the Public and Private sectors, and are currently in the final stages of device registration and regulatory approval in South Africa.”

What problems is EHealth addressing

Some of the biggest challenges in the healthcare sector around the world today are lack of skilled medical professionals in general, lack in training opportunities, there being no quick fixes to complex problems, lack of skilled specialists, urbanization and congestion, and the environmental impact of being one of the most waste-prone sectors.
Mr. Martin:

“With a virtual exam room and other EHealth solutions access to quality care is no longer limited by geography. Healthcare providers can overcome the barrier of distance, increase patient access to care, and work more productively. Digitization also has the potential to reduce the level of waste in the sector.” Whereas some express concern technology creates a distance between people – and personal attention being so vital in healthcare specifically – if the right technology is put in the right place, the opposite takes place.

The public health sector has a reputation for being resistant to change (especially digital ones) as well as being very slow to adapt. This is also why most EHealth professionals seem to agree on the need for ‘hand-holding’. Whatever changes might be proposed, be it in South Africa or elsewhere, intensive and long-term training of the healthcare workers meant to implement them is key if one wants to ensure the sustained success of digital solutions in health.

In Summary

Digitization has enormous potential for positive effects on healthcare world; for healthcare workers and patients alike. Innovations in the public sector have to be accommodated by proper training and assistance in implementation, and of course any privacy and confidentially concerns should be addressed.

What we mustn’t forget is that most health workers tend to be more overworked and underpaid compared to their colleagues in other sectors. Dr. Mapham reminds us that: “The people who deserve the most praise are the many administrators and health workers in the public sector, which serve +/- 80% of the population of South Africa. Special mention goes the the HoDs who have embraced innovation and are working hard to make their departments as efficient as possible.”

We might still be far removed from going through our yearly physical from the comfort of our living room, but South Africans all over the country are already much more able to access healthcare through their local health workers’ ability to reach out to a specialist via digital means, advances in patient and epidemiology data management and sharing, and hopefully soon having access to a local virtual exam room at a clinic nearby.

If you would like to read more about the advances of EHealth in South Africa and worldwide, check out www.ehealthnews.co.za

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This article was made possible by the contributions of the following people: